Home visiting support for people with hikikomori (social withdrawal) provided by experienced and effective workers

Abstract

Objectives: Hikikomori – an almost complete withdrawal from social interaction first seen in Japan – is becoming an emerging psychological syndrome worldwide. The mental health community in Japan has focused on hikikomori since the 1990s. Hikikomori was initially considered a culture-bound trait, unique to Japan; however, it has become an international concern, and cases have been reported even outside of Japan. While home visiting support for people with hikikomori has gained popularity, an effective solution remains elusive. This paper describes the process involved in effective home visiting support provided by experienced workers to help people with hikikomori. Method: Semi-structured interviews were conducted with 21 home-visiting support workers in Japan. Collected data were analysed using a constant comparative method based on Grounded Theory. Results: ‘Supporting them in finding their own way to participate in society’ was identified as the core category. This core category was substantiated by following three interrelated stages: preparing the involved surroundings for reaching out to a person, maintaining constant communication and expanding the range of activities and relationships. The process encouraged people with hikikomori to enhance their social connections and improved their motivation for social participation. People with hikikomori experiencing despair and isolation began to find pleasure in social participation through the three stages of support provided by home-visiting workers. Conclusion: Our study suggests that Home visiting support for people with hikikomori can be enhanced by these three interrelated methods which can help individuals integrate into society and connect with others.

The impact of higher levels of autistic traits on risk of hikikomori (pathological social withdrawal) in young adults

“…As noted, however, causality needs to be established, as a reduced level of leaving the house may be an index of other factors, for example a marker of social isolation. A recent intervention for hikikomori in Japan has been to send people into the houses of hikikomori [ 63 ]. Gavin and Brosnan [ 47 ] also found that using social media ameliorated hikikomori risk during lockdown.…”

Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori

“…Intervention. Even though few evidence-based interventions have been established, pharmacotherapy (if the individuals are comorbid with psychiatric disorders) [ 3 ], a variety of psychotherapy [ 14 , 47 , 48 ▪ ], social work [ 3 ], and family approach have been provided [ 51 , 52 ▪ , 53 ]. Precision (individualized) approach is recommended based on the above assessments [ 54 , 55 ].…”

Contemporary Hermits: A Developmental Psychopathology Account of Extreme Social Withdrawal (Hikikomori) in Young People

“…Therefore, the threshold for the intervention should be kept as low as possible. In many countries, home visitation programs have been launched to detect, evaluate, and eventually treat socially withdrawn people, which seems to be a logical approach given the nature of the problem (e.g., Japan: Funakoshi et al, 2022 ; Hong Kong: Yuen et al, 2019 ; Korea: Lee et al, 2013 ; Spain: Malagón-Amor et al, 2020 ). Oftentimes (initially) social workers—and not clinical psychologists and psychiatrists—are involved to prevent pathologizing and hence to maximize the chance of a positive acceptation of the help (Li et al, 2018 ).…”